Provider Demographics
NPI:1285279208
Name:FARMAR, JILL BYNUM (MD)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:BYNUM
Last Name:FARMAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4611 TRAVIS ST APT 7
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-5581
Mailing Address - Country:US
Mailing Address - Phone:214-727-7239
Mailing Address - Fax:
Practice Address - Street 1:4611 TRAVIS ST APT 7
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-5581
Practice Address - Country:US
Practice Address - Phone:214-727-7239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6426207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology